Genital Warts: Rapid Evidence Review

Area of Science:

• Dermatology
• Infectious Diseases
• Public Health

Background:

• Genital warts, or condyloma acuminatum, are primarily caused by human papillomavirus (HPV) types 6 and 11, accounting for 90% of cases.
• Transmission occurs mainly through anogenital contact during sexual activity, with vaccination offering effective prevention.
• Prevalence in the US (2013-2016) was 1.3% in men and 3.1% in women aged 18-59, with conflicting evidence on condom use impact.

Purpose of the Study:

• To review the epidemiology, clinical presentation, diagnosis, and treatment of genital warts.
• To highlight effective treatment modalities and preventive strategies, including vaccination.
• To discuss diagnostic considerations and management options based on current evidence.

Main Methods:

• Clinical diagnosis based on lesion appearance (single/multiple, coalescing, color, morphology).
• Biopsy indicated for atypical lesions.
• Review of patient- and physician-administered treatment options, considering efficacy and recurrence.

Main Results:

• Podofilox 0.5% solution is the most effective patient-administered therapy.
• Carbon dioxide laser therapy, surgery, and electrosurgery show high efficacy for wart removal.
• While all treatments have some recurrence risk, most successfully treated warts do not recur.

Conclusions:

• Genital warts are common, preventable by vaccination, and treatable with various methods.
• Shared decision-making informs treatment choice, with specific therapies recommended for patient- or physician administration.
• Podofilox, imiquimod, and sinecatechins should be avoided during pregnancy.